Dear Doctor: Could boxed macaroni and cheese really be as bad for you as news reports suggest? Sometimes, that's all my kids will eat.

Dear Reader: The recent news about the presence of chemicals called phthalates in boxed macaroni and cheese sent a shockwave through many American kitchens. Affordable, easy to prepare and beloved by the younger (and let's face it, more than a few of the older) members of the family, pre-packaged mac and cheese has become a mealtime staple.

However, a study funded by an advocacy group called the Coalition for Safer Food Processing and Packaging raised an alarm earlier this year. Testing for phthalates -- a family of chemicals used, among other things, to make plastics flexible -- the group reported measurable amounts in 29 of the 30 cheese products. These include boxed macaroni and cheese, as well as soft, hard and natural cheeses.

Concentrations ranged from 0.6 parts per billion to 295 parts per billion, with the lowest in natural cheeses. The highest were found in cheese packets in boxed mac and cheese. In all cases the phthalates migrated into the food via the packaging.

The chemicals, many of which were banned from use in infants' and children's products in 2008, are known as endocrine disrupters. That is, they interfere with the working of the body's hormonal system. Exposure in high amounts can affect fertility in adults, and is associated with disruptive behavior in children.

All of this sounds quite alarming. But before you banish all cheese products from your home, let's take a closer look. The concentration at which phthalates begins to cause problems is not known. Yet the study labels the 0.6 parts per billion to 295 parts per billion of phthalates that were found in the tested products as a "high amount." Additionally, the Centers for Disease Control and Prevention have found that, although we encounter phthalates in a variety of products, combined exposure remains extremely low.

To be honest, we think if you're going to be worried about the health effects of boxed mac and cheese, all you really need to do is read the sodium level on the nutrition label. And while mac and cheese out of a box is easy, sooner or later, for your children's long-term health, you'll have to bring fruit, veggies and other building blocks of a healthful diet into the mix.

Maybe start by making the boxed mac and cheese a special treat on a certain day of the week. Or find a recipe the family likes and make mac and cheese from scratch. It may not be as fast, but it's far more healthful. And, yes, we know these changes aren't easy. As parents ourselves, we face the same challenges of pleasing a picky eater's palate.

A final word: If the mac and cheese study has you worried about phthalates in general, take steps to cut them out of your food chain. Never use plastic in the microwave, as the heat can cause the chemical to move into your food. The same goes for the dishwasher -- wash any plastic ware by hand. For the greatest peace of mind, skip the plastic ware altogether and switch your food storage to glass or stainless steel.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: My grandmother has a daughter and a son with Huntington's disease, and her husband and a few of her in-laws passed away from it. What can you tell us about this terrible disease? Who in the family could yet develop it?

Dear Reader: "Terrible" is the correct description of Huntington's disease. It's a rare genetic disease -- affecting about 5.7 out of 100,000 people in Europe, Australia and North America -- but it's unrelenting and eventually leads to death.

Almost everyone with Huntington's carries a disease-causing mutated gene on one chromosome and a normal copy on the other chromosome. That means their children have a 50/50 chance of having the mutated chromosome passed down to them. Unfortunately, in Huntington's, the mutated gene is dominant. So, even if a person has only one of the abnormal genes, he or she will develop the disease. So, to answer your question about the potential for other family members, any children of your grandmother's daughter and son with the disease have a 50/50 chance of developing it as well.

In the rare cases in which a person has two copies of the Huntington's gene, he or she will without doubt pass the disease on to all their children. Further, children who get the gene from their father are more likely to develop the disease earlier in life and to experience a more rapid deterioration.

Here's what happens: The mutant gene in Huntington's disease produces an abnormal protein that damages both the nucleus and other components of nerve cells, killing them. The nerve death is especially severe in the area of the brain called the striatum. These changes can be detected via MRI between nine and 20 years before a patient shows symptoms, which typically occur between the ages of 35 and 44.

The first sign of Huntington's disease is an involuntary movement abnormality termed chorea. Initially, this may be perceived as restlessness or lack of coordination. When it worsens, movements become random, jerky and uncontrollable, making it difficult for a person even to hold his or her posture or maintain a sustained motor action such as sticking out the tongue.

Psychiatric symptoms of depression and irritability, which can occur at any time during the disease, may be noticeable even before the onset of chorea. An estimated 33 to 76 percent of patients report anxiety, depression or apathy during the course of their illness. Three to 11 percent report symptoms of psychosis, including hallucinations, delusions and paranoia.

It gets worse. Patients' cognitive abilities are affected as well, leading to difficulty making decisions, multitasking or switching from one mental activity to another. Eventually, the memory problems lead to dementia.

In the latter stages of the disease, people may develop a rigid muscular state similar to Parkinson's. This can lead to the inability to walk. People can also experience weight loss, vision disturbances, and difficulty swallowing and breathing. The progression is prolonged, with death generally occurring 20 years after onset of symptoms.

Although genetic testing can easily diagnose the Huntington's mutation, the availability of such testing is relatively recent. Further, while it can guide decisions about whether or not to have children, it can do nothing to change the current reality. My heart goes out to your grandmother and the rest of your family.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Proton pump inhibitors, which I take for my severe heartburn, have made my life enjoyable again. Now I'm reading that they may cause kidney damage. How serious is the risk? I really don't want to give them up.

Dear Reader: Severe heartburn, which is the burning sensation behind your breastbone that comes on after a meal, can be debilitating. Caused by the presence of stomach acid, it's an irritation of the lining of the esophagus, the muscular tube that runs between the throat and the stomach.

When things are working properly, a ring of muscle fibers in the lower esophagus prevents the contents of the stomach, including the powerful acids that break down food, from moving back up and damaging tender tissues. This ring of muscles is known as the lower esophageal sphincter, or LES. However, in some people, the closure of the LES is incomplete. This allows the stomach acids to back up into and potentially damage the lining of the esophagus, which is known as reflux.

Proton pump inhibitors, or PPIs, are extremely effective in alleviating chronic and severe heartburn. They reduce stomach acid by blocking the action of an enzyme in the wall of the stomach. But numerous studies have raised serious questions about a potential link between PPIs and kidney disease.

A pair of studies published in 2016 in the Journal of the American Society of Nephrology and JAMA Internal Medicine looked at information collected from tens of thousands of patients in two separate databases. The results backed up the previous research -- that patients taking PPIs were at higher risk of developing kidney disease than individuals who used a different class of drugs, known as H2 blockers, to address the same digestive issues.

In the two 2016 studies, it was found that the risk of developing kidney disease was increased among patients who took PPIs twice daily. Additionally, that risk rose over the first two years of PPI use, according to the results of the studies. The studies addressed only prescription drugs and not over-the-counter PPIs. This is because the data relating to non-prescription PPIs are not readily available.

Although some experts in the field of nephrology now believe these drugs may cause harm in some cases, others suggest that the studies, which are observational rather than clinical, have significant limitations. Additionally, the data pool includes many individuals who are already in poor health. Experts who are taking a more cautious approach suggest this makes a direct connection between PPIs and kidney damage more difficult to prove.

As to your own situation, we think it's important that you make an appointment with your family physician to talk things over. First of all, it's possible that there may be non-medical alternatives to managing your chronic heartburn. Losing weight, eating smaller meals and changing your diet can be surprisingly effective. If it turns out that your physician feels you do require medication, discuss the option of using H2 blockers, medications which also reduce stomach acid. While not quite as effective as PPIs, switching away from PPIs may give you peace of mind.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)